How to Build Better Sleep Habits in the New Year (and Improve PAP Adherence)

Intro and guest introductions 0:00

Sleep Tech Talk is brought to you by Fisher & Paykel. Fisher and Paykel Healthcare is a leader in CPAP mass design and innovation for over 20 years. Their unique technologies have benefited millions of OSA patients through their top CPAT mass. These advancements continue to further enhance patient experience and outcomes. All right, everyone, it's another day and that means another podcast. And when it is another podcasts, It's time for pre-calibrations. What is going on today? Jerry, we have a couple of great guests with us today from InHealth and CoachLink.

We have Aubrey Sawyer. Aubry is a category creating co-founder and health co innovator known for building systems that activate human behavior at scale. She co founded In Health more than a decade ago, turning a deep focus on how people actually change into one of the most clinically credible behavioral activation companies in the country. backed by NIH-funded trials, peer-reviewed research, CDC recognition, and national payer distribution. Today, she's extending that work through CoachLink, a modular behavioral AI infrastructure built from InHealth's foundation and designed to layer into any healthcare technology platform to engage people in their health before motivation exists.

So we're going to welcome Aubrey, but along with Aubry, we have Dr. Michelle Allencar, Dr. Alan Carr is the chief science officer and co-founder along with Aubrey. And she is a behavioral scientist and professor whose career centers on understanding what helps people sustain health behavior change over time. She co founded InHealth where she helped design the research training and evidence based behind nationally scaled clinically validated coaching programs. Alongside her academic role at California State University, Long Beach, Michelle now leads the scientific development of CoachLink, applying behavioral change science through adaptive modular technology that translates evidence into real world healthcare delivery.

So we have a couple of really heavy hitters on with us today. I'm excited to see where this goes. You know, I have, a little experience with these guys. Kind of unfold with us today. I think it's exciting to have some health coaching as we launch into the new year. Hey Emerson, I have some experience with this team also. I didn't realize going into the call today until I started to see the names and the name of the company because I think I missed, somehow I miss who they were but I worked with them back in my time at Apria and they absolutely changed the trajectory of our patient engagement, patient outreach, and just the overall strategy from a coaching perspective for us as a company.

And again, I was a little skeptical at first, but they absolutely changed my mind and became a big part of the success story in rolling out a successful sleep coaching initiative at Apria. Well, I have not experienced either of them. So this is going to be interesting for me. But I will tell you, the whole coaching aspect is I find fascinating and the science behind that. How do you get the most out of it? In fact, Emerson, and I think I can remember which conference it was. You actually spoke to that about coaches and how you're able to get best out people.

It's going be very interesting to say that and to your point earlier about New Year and health goals and things like that,

Behavior change, resolutions, and habit stacking 3:40

I think this is the right time and the the group of people for us to talk to. Let's see what they say. All right. On to the show. Lights out. Welcome everyone once again to another episode of Sleep Tech Talk, the sleep podcast with your hosts and friends, Emerson Kerr, Robert Miller, and me, Dr. Gerald George Moneykerode. Folks, as always, we've got a fantabulous episode for you all. But this one extra special because it is something to bring in the new year. And we always hear about New Year, New You.

I don't know how new you it's gonna be, but... It's your three friends over here once again talking to you with some special guests. But before we get started, we want you to know that we thank you so much. For the past several years, you have been by our sides and we have grown tremendously. Thank you, so, much for that. Not everybody is subscribed to the show out of the thousands and hundreds of thousands of people that are watching now. Be sure to just hit that subscribe button and while you're at it, hit the like and be sure share and thank you all so much for that.

And a huge shout out to our sponsors for helping us get to this level. Without them we couldn't do this and folks out there, be to check them out and give them a shout as well. With that being said, Emerson, what's going on today? Well, hey Jerry, we have some great guests with us today. As we are kicking off the new year, I'm everyone starts to think about their new result years resolutions and things like that and we have the CEO and co founder of in health and coach link as well as the CIO the chiefs are seat chief science officers got sorry and Co founder we had all the Sawyer.

And Dr. Michelle Allen car with us today and welcome ladies. It is absolutely fantastic to see you. We have a great history together during my time and your time a little bit at Phillips and I got introduced to in health and. with such a treat to have you on our show. You, as we head into this new year, uh, there's a lot of people talking about new years resolutions. They are ready to reset and get healthy. Aubrey, you know, is as you think about what you guys do at in health and this topic today, tell us a little bit about in-health and coach link and, and of course, Dr.

Alan Carr, if you can to jump in and share, but We want to hear from you. What is it that someone could benefit from by connecting with you guys and your organizations? Yeah, thank you so much for having us today. It's so good to see you, Emerson. Oh my gosh, it's been too long. But just so excited about the work that you all are doing with the Sleep Tech Talk podcast. That's going really well, that's awesome. So thanks so for much having. Yeah we are celebrating our 10th year in business actually.

We have been doing this for a decade now. I can't even believe it. But yeah, I mean, we have been obsessed with human behavior for a very, very long time. And it's finally coming to the point where people are recognizing that that really is truly the front door to human health. is our behavior, right? And a lot of that has to do with what we teach and what strive to have our patients really incorporate into their lives through the lifestyle therapeutics component of everything that we do. And at the top of the list is sleep.

We've built this program really centered around seven pillars of health. Today we have 11 peer-reviewed publications in all different kind of areas of health, whether it be sleep, adherence to medical devices, diabetes, hypertension, smoking. I mean, you name it, we've done studies on it. We have randomized control clinical trials that we have done that were funded by the NIH, some of the first of their kind actually, 10 years ago. Before really lifestyle and coaching was really even mainstream.

And I guess what I could say is in terms of kind of New Year's resolutions and things like that, it's thankfully becoming more of a trend for people not so much to set New Years resolutions anymore, but more focus on the things that they can add to their lives that are going to help with their actual and their change in their lifestyle. And so I'll let Michelle talk a little bit more about that. But yeah, in terms of what InHealth is doing today, we're doing what we've always done. It's all about behavior change.

it really is. and now we are adding on the other layer of the AI, which is CoachLink, and we can talk about it a bit later. I will let Michele talk more resolutions and our thought process on that and where we kind of drive our patients. Yes, thanks Emerson, Robert, Jerry. Thanks again for having us. You know, I think when we think about our resolution, we have to understand that willpower is a very fragile fuel source, right? By just relying on will power, you're not going to get very far. So when you think the behavioral science side, which is where I get my jollies, it's that intrinsic motivation and the identity that base our habits is far more durable.

When we start to stack on top of that habit, that's when things become more likely to be You know something that we do in the long term. So for example for taking the stairs, you know up the Stairs to go to our workplace doing that, You Know instead of two days we're doing That five days. so when we start to think about these resolutions we Start to help people change their current behaviors that adds on to those behaviors versus trying to start something brand new. So when we think about New Year's resolutions and we thing about things that truly matter to us for our health, one thing I leave to these listeners is, think of what you're already doing and think how you can stack those behaviors on top of each other.

What we do in our methods in health and what we're building on the AI side at CoachLink is how do we that in a very realistic way that's meaningful that you could actually do it in the long term? So it's focusing less on outcomes like weight or maybe specific sleep scores, or it is more focusing on the process that base those behaviors to reinforce that capability that you are already doing. So again, I could talk about this stuff all day, but that's what I would leave this group with right now on resolutions is habit stacking.

What can we start to stack meaningfully? What could we add on top of what we're currently doing? And what do we see ourselves doing this week, next week this month, and maybe three months? Let's stop there and reassess.

Coaching process and breaking goals into steps 11:30

And so that usually that the methods of we do and the foundation of our methods for the in-health side. That's awesome. I, you know, full disclosure, I got to work with you guys for a few months and it was so fun because not only was I helping you sell the program, but I've got it to be a bit of a guinea pig and get to experience it with super coach Katie Sims. She was awesome and you the thing that I found fascinating because I think a lot of us have had coaching experiences with our insurance companies and things like that is the level of engagement, focusing on what is that big thing you want to live for and what do you wanna grow to?

And it was just so fascinating how your seven pillars of health and this gradual growth process with goals that were attainable. We weren't setting a goal that was unreachable as much as setting one that we could reach week after week and then month after month in your growth processes. So, Michelle, when you think about that, Can you kind of break that down a little bit? Because that's really a beautiful process that you put together that really helps the person, like you said, with habit stacking, but really, helps them achieve these goals in small bites.

Can kind you break down and why that is as successful as it is? Yeah, great point, Emerson. I'm really glad that you got to enjoy that process and got see it firsthand. It makes me very happy that we got talk about that. But the process is simple for us, right? And so when we started, like Aubrey said, 10 years ago, we saw a clear disconnect of, you know, patient sees the medical provider, now what's next. So what we do really well is we translate the what to the how. And that's it, right? So we received a prescription, we receive the medical device, We received something.

How do we put this into action? And thats what we do beautifully. So for our processes,we receive a referral or we recieve an order from a medical provider. What that does is it helps our coach to understand what the medial side and what that needs to be. For example, this can be anybody, if you've received the medication or medical devices or other diagnoses, How is the next step? So for us we we connect that individual with a health coach and we start to understand that individuals behavior what intrinsically motivates them and We start To create these little baby steps to create realistic smart goals that are attainable for that Individual so we break it down into a longer-term vision six-month goal We break It down Into 30-day goals and, we Break it Down Into weekly action steps and And what that means for us is we can see where do we want to be, where can we be and what do you need to do to get there.

And so by creating these small actionable steps, like I mentioned before those habits stacking momentum that you do, you start to build towards this vision that And so if that includes, let's say, a CPAP or other type of sleep tracking device or whatever it may be, you may have these questions that come up in between. So maybe we'll start to talk about usage and usage per night and those things. By understanding where we want to be we can start use the data or use momentum that we've created to get to where want be.

For us and for those that are listening, it's actually very simple for us. Figure out where you want to be, break it down, and then create little action steps in between. And when we have our coaching process, that's essentially what we do. We're definitely the cheerleaders that help with that to drive momentum. And I think it's really important to also mention the process to get there with a patient to to the point where they're actually motivated to change. So when a patients comes to us, they they are not necessarily motivated change every time, right?

They've been told by their doctor or they've referred to as for because, you know, their struggling with hypertension or have sleep apnea or, there are all kinds of different reasons that they get sent to. Humans don't love to be told what to do. So it's our job to get people to pull those intrinsic motivations out of people. Something that we do really, really well is when someone comes to us, okay, they might come to use because they need to lose weight, right? Because their weight is affecting all kinds of different parts of their health.

Okay, They come us for weight. But what we start with is we started with having them rate themselves on the different pillars. How would you rate yourself on purpose? How you would rate yourselves on your stress levels? And of course that's the first thing that people think of. Nutrition and fitness. Okay. Well we might find with somebody that they rated themselves a 1 on Purpose. And they don't really know why they're getting out of bed every day. And so we won't even talk about their weight for it could take two months before we even touch on their wait because we need to address their purpose first.

And so that is when you really, that's where the magic starts to happen because we're not telling them what to do anymore. We're letting them guide their own process and build their motivation to now, okay, now we are two months in, all right, I've got my purpose. Now I know what I'm really going for and this is where we start to get that change, because now they start ask us, okay, how can I do this? What should I for that? what should i do for this versus us telling them, you need to do, this you, need, to, do you do.

That's what that's that the beauty in what we do a sound sleep calls for a high-performing mask introducing f&p nova nasal with swing fit headgear from fitting and seal to minimal noise and draft is performance defined go to fphcare.com forward slash nova, nasal to learn more So what type of tools from a sort of a digital and in-person experience are you able to use to be able deploy that type strategy? So today we're doing it a lot of different ways. We do this through our direct provider channels.

So one of the beautiful things that we've done in the past and sleep medicine as an example, you know, where it's as simple as a doctor or medical provider sending a referral over and that's how they're connected to our health coaching team. That's where we can be that's how we intersect today what we're building is actually extremely exciting because what We have identified through the decade of inner human interactions that we've had the hundreds of thousands of chart notes that clear process differentiators that have happened over the years, that we can do this so much better by leveraging AI and a full behavioral infrastructure.

So we're actually building that. And that's the beauty of what CoachLink is going to bring to the market is helping to identify motivation and driving motivation before it even exists. So we've seen hundreds of thousands of individuals come to us, just like the scenario that Aubrey described. I just got this CPAP and now I don't know what to do with it, or I didn't even want to. Do my sleep study because I'm scared of what it might tell me. That's where Coach Link is going to sit because it's going help to drive motivation.

Even before we got in there, it is taking them through this process of finding their own motivators inside and so. We could talk about that too, but it's coming and it is exciting. So the services that you offer today, I know that they are very specific relative to the individual. But if I can go back and I also have an experience in working with InHealth in the past, because you guys helped to build out a sleep coaching program for a national DME company. You guys were able to take a group of customer service reps and turn them into certified sleep coaches, albeit an internal certification.

Tools, AI, and CoachLink infrastructure 19:40

But it was funny because I felt like going into it, I was a little skeptical about the ability to deploy the program fully. But you absolutely delivered without question. And, you know, at the end of it, it was interesting to hear some of the feedback that, the courses and the training, It wasn't easy for the people who were participating in it. But it helped to refine them in a place and get them to a space where they engage patients in very, very different way. Oh, yeah, driving behavior change is not easy.

And there's a lot that goes into it. I mean, there is an actual board certification process for this that is a very difficult test. It's governed by Michelle. The National Board of Medical Examiners. So same like other medical credentials. Same as other medical credentials. So it is a rigorous process for them to get certified to do this. And what's really exciting about AI and where we're kind of headed is that because we've built the infrastructure and we have done the research, we all the data with the hundreds of thousands of chart notes, and actually have an accredited academy, We can take that and now send the AI through the same rigorous training.

And now we've got guardrails built around our AI to where it's not dangerous anymore, right? There's a lot going on with AI, especially as it pertains to healthcare that is very dangerous. It could be telling people, I mean, cause it can hallucinate and tell them to do all kinds of stuff that a provider would have never told them do. This is the value of what we bring now is these years and years of all of the data and the science behind all it. And the accreditation that we used with your company, Robert, where we were able to train the humans.

Now we can train AI to do the same thing and then get the people motivated and engaged before we send them to an expensive program. So we need to figure out what is the program that they even need be going to, who do they need even be talking to first. Now we'll send them to the programs versus sending them without them being motivated, spending all of that money and having them drop off after 30 days. So this is what we're building now in terms of what, we do on the side of in health and the whole kind of activation and.

The whole deployment of our program. I mean, that can be looking at data and having that integrated into the platform. Of course we have weight scales integrated. Into the. We have blood pressure costs. You know, diabetes devices, all of those devices are all integrated into the platform. But at the end of the day, it comes down to the relationship with the coach. That's really what it come down too. You can look at all the data in the world, but it really comes to that relationship. So, Dr. Michelle, a question for you is, now, these guys are going to make fun of me about this, but I actually read a book.

But there's a books called Atomic Habits by James Clear, and he talks about habit stacking. Now, the challenge here is what you brought up. You may know the why and you may not know what, what the how is the challenging part, right? From what you both are saying Aubrey, you and Doc here is that that's where you actually help them is the how part to from the intellectual aspect of I know I need this, I needed to do these things, but how do I get there? Am I correct in saying that? You're absolutely correct.

And that's where the magic happens differently for each person. Everybody's why is different. Maybe it's to have more energy to play with their grandkids or maybe it is to walk their daughter down the aisle for their wedding. There's something there that is driving that individual as an example. But how do they do it, is all very different and so the coach is there to, you know, kind of pull on all those strings, right? For us, we've been seeing this for a decade happen in a human model that we see it as a very beautiful relationship now to be able to do this in the tech space and be doing this with an infrastructure that makes sense from various different verticals.

And so by understanding habit stacking, that's the foundation. But from here, Going all the way up like the DME is helping with reorders and resupply and seeing, you know, why are they not reordering or looking at it from a pharmaceutical perspective? Why are we not refilling prescriptions? We see it go so far up the chain because it all boils down to that exact. that exact component, right, is how. Everybody's how is different. Once you can figure out that connection, you start pulling it from one string to the next.

And that's why we keep driving engagement. In our publications, we have some of the top levels of engagement out there. That's because of that reason. We figure it out, figure how to drive the how, and we key that engine churning over and over again. I think one of the fun experiences I had with you guys as the pseudo patient was the accountability part. And I remember doing the photo of my dinner that night and I was so proud of it because I have this shrimp dish and it had all this butter. You know, when I sent it in, I so was proud and then Katie says, that's a lot of butter with your shrimp as opposed to the other way around.

But you know what it did help is not just all of why and how, but that accountability. that the patient has or to your point, because whether it's a CPAP or a meal or the exercise or whatever that, or even back to purpose, it really always tying these pillars back again because I think they all matter in the grand scheme of things. So as you look at this and you kind of forward in what you built with Coach Link, how does all that fit together? Because that's quite a puzzle. How do these pieces all fit You know, I think it's pretty simple for us and it goes back to just how we train our human coaches is how are going to train this infrastructure.

When you think about the dimensions of health and sort of what factors are involved there. It's physical, it is mental, you know it all of those different components that are all pieces. So when you the EMR data is pulled in, the interactions that they have with other tools, whether it be an app or a device or others, their social interactions, how do they interact with. Other individuals and so all of those pieces are all funneled into this engine that we've created to help. the AI learn from each of those different pieces of that individual?

We see more, like I said earlier, how often are they reordering their device pieces? There's so many things that are part of this engine that would spit a different output out for each person. What would spit out, for me, what would be different for you, or Aubrey, because of all these different factors. And the way that we train our humans is to really understand these layers, and we have priorities all the ways from the top down on how we would touch

Accountability, behavioral codes, and goal setting 27:30

on it, but everything gets served up in that fashion that's meaningful for that individual. I don't know if that makes sense. Yeah, I mean, everyone's behavioral code is completely different. And so this is going to be able to unlock the different behavioral codes of every individual person that comes through. So what might motivate you, Emerson, to take the butter off of your shrimp, right? might not be the same motivation that somebody else needs. What really drives that accountability for you might be not the the accountability of someone else.

I always go back to the story about my husband being diagnosed with hypertension and all of a sudden from his employer benefit plan, we get this box on our doorstep with a weight scale and a blood pressure cuff in it. He didn't ask for that. And he is the last person to use a device, download an app, start looking at his metrics and his data. Like, he's the person. Me, I want to know, like, how many breaths did I take last night? I wanna look at my labs, every week, if I could. You know? Like I wanted to look all of that stuff, right?

So that's what keeps me accountable. For him, what keep him accountable is something totally different and unique. And that what we're able to figure out on a human level right now. And what we're going to be able to figure out with the AI is what is it that's keeping you adherent? What is that holds you accountable? what Is your behavioral code? And we need to crack that with AI. So we are getting people into the right programs and getting them the therapies that they actually need and that the use.

I love that. So before Jerry calls time on us, I'm thinking about our listeners in 2026, and as they are sitting here thinking their goals for the year, how can they begin to think about that? And what's a healthy way to approach the new year and set the right kind of goals and motivations for themselves? I think this most simple way to think of it as you know where do you want to be right so what's that ultimate vision. How do You back it down for yourself so whether it be a let's use a weight loss goal because I would say that's the majority of individuals New Year's resolution is tied to wait to some fashion.

Try to think less of the outcome of what that number is and try to Think about what That outcome means to you. Does that mean more energy? Does That mean More Longevity? What does it mean to You to have that weight reduction? Less of The outcome and more of What that means. When we start to break that down, you start To see what those layers unfold. So let's use the energy example. If having more Energy is really what's focused for you, Now we can start to think about what would that mean and what that would take.

Maybe it's reducing saturated fats or starting to increase more of your activity and breaking it down into those small bite-sized fashions, but always thinking about you're currently doing and adding on top of that. That's the best-case scenario in terms of supporting a longer-term goal attainment. I'm sorry, go ahead, Aubrey. I said she said it perfectly. Leave that to the scientists. There you go. Well, I appreciate that. And thank you all so much. But we are out of time. Where can people get more information about in health and Coach Lake?

Yeah, so they can go to inhealthonline.com and that's where they're going to find, they'll be able to link over to the CoachLink page. You can find all of our research there and our publications. see us, our leadership team, some of our coaches are on there. But yeah, it'll give you more information on how InHealth works and then also how we're starting to integrate CoachLink and the new AI technology into this whole behavioral science mechanism and healthcare ecosystem. Fantastic. Well, ladies, thank you once again for joining us.

This has been an amazing conversation. Way too short, right? Yeah, yeah. It does go by fast. You said it would go Yeah, it does. But thank you all so much. And folks out there, we sincerely appreciate you joining us. Once again, don't forget to like, subscribe, and share the show with all your friends out, they're all the sleep professionals and sleep curious. This particular episode, all those who are looking to get healthier in the new year. Don't forgot to check out our sponsors. A huge shout out to them.

Until next time, We Say Lights On. Be sure to check out our clinical sponsor, Sleep Review Magazine. More details in show notes. All right. Another show, and it was quite a show. Really jam-packed. And you know that means it's time for post calibrations. What did you gents think? You know, I went into this with some experience of knowing these guys and these ladies and you know one of the statements that they made that was just really powerful even wrote it down was willpower is a fragile fuel source.

And I love that because you think about how everyone is looking at the new year and their resolutions and they've got all this willpower. And, I know my gym, almost want to take two weeks off because it's going to be jam packed for about two and then everybody will kind of thin out. But I think that speaks to that is everybody comes in with this Willpower, they just spent two week overeating. eating all kinds of food and now they want to trim down for summer and that willpower fades away. And I think what InHealth is doing really speaks to that.

I love that statement, I'm actually going to keep that on my desk because will power isn't enough. There has to be a process. You mentioned James Clear in the show, but he says that people rise to the level of their processes and I really think this speaks of that, so great episode. Well, I'm glad you mentioned the author, Emerson, because I have to say and give you some props, Jerry. This is the best application of a book that you've read in one of our conversations. You had them shaking their heads, so you absolutely hit the nail on the head today.

Hey, I read once in a while. I understand words, but thank you. Yeah. But to the limited, the limiting factor of what was the word that she said? Willpower. There was a book out there called motivation as a myth, which talks about that sort of thing. People looking for motivation, looking towards willpower to help them to do things. You need to have these processes, you need the how, because all the resources such as motivation and willpower does get drained, though there's only a fine out amount of that within each person.

And, uh, I thought it was fascinating to, to hear the doctor talk about it. And then Audrey talk. How, how it's actually implemented.

Wrap-up and post-show reflections 35:00

Interesting that you can apply that to any, you know, almost anything in life. Um, as we were kind of talking through it, and I think, during the episode I was thinking specifically sleep and sleep coaching and, but as you just sort of articulated it there, Jerry, um, You know it sortof resonates for anything. you know, sales, the how we go about our daily work, you in what our work habits are and even how he treat people, all of those things. So this is really powerful information. Well, and for clinicians out there, one of the things about what in health is built is it's not just that they've got a great coaching program.

but in their clinical practice, our listeners who do have a clinical practise, they can work with InHealth to build out a program. So it's not just, hey, this is great for our listeners and they become clients, but how can they work somebody like In Health to building infrastructure and a process because, and we've got coaching friends all over across the country that have similar programs, But they're all kind of at the center of it. How do we create success for sleep patients? Because just like we're talking about with this, you know, the motivation isn't enough.

There's got to be other things, there's gotta be the why and the how and accountability that pulls that person all the way through. And that's what these do and what they've done at InHealth and especially with their peer-reviewed articles and everything they have done is just so incredible. You know and in the credentials that their coaches hold. I mean, it's not an easy achievement to be an accredited health coach. And as they pointed out, its all recognized by the AMA. So beautiful program, fantastic leaders.

They've done a great job putting this together. It's exciting to see where they've taken it since I worked with them quite a few years ago now. Well, I think that's absolutely amazing to hear and I look forward to hearing from our listeners and viewers if they tried them out or if the plan to try them in the future and i think it'll be fun to here about that. You know, I'll say one more thing because I know we're getting ready to wrap this part of the show. I'm actually surprised they haven't been acquired by a larger company yet.

The work they're doing is super valuable, and it seems to me that a large company would want to come in and acquire their business versus try to build something out themselves, which would be a pretty difficult task. So just put it out there for the in-health folks that it would a hot commodity if you were on the market. That truly makes a lot of sense. I would agree with you there. They're a great product. Well, folks out there, thank you so much once again. Cheers and Happy New Year.